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NASBAC APPLICATION FORM I would like to apply for the class/course (checked below) with my intention of joining NASBAC (California Flower Art Academy) * are required items. PERSONAL INFO Name of Applicant*   first  last Address* street address, apt/suite # city   state  Zip code country Phone no.*    area xxx-xxxx e-mail*

CLASS INFO Type of Class(Check any applicable classes)* Shadow Box Art Decoupage Selection of Course (Check any applicable courses)* Elementary Course Intermediate Course Advanced Course Instructor Course Others   Upon NASBAC's official acceptance to my application, I will follow further procedures as required by NASBAC in order to complete the arrangement for admission. Date of Admission:*   ( 04/24/2002 )

QUESTIONNAIRE: I am providing the following information to NASBAC for your reference: (Check any applicable ones and state the information if any) I have learned Shadow Box Art in the past for years/months. I have learned Decoupage in the past for years/months. I became to know NASBAC from one of my friends/acquaintances. I became to know NASBAC from any Advertisement in Telephone Book I became to know NASBAC from any other Advertisement (specify here: ) I want to learn Shadow Box Art/Decoupage for my hobby. I want to learn Shadow Box Art/Decoupage for my business purpose.

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